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Surgery > Sterilization & surgical pack prep > Flashcards

Sterilization & surgical pack prep Flashcards

1
Q

what is antiseptic

A

antimicrobial used on skin

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2
Q

What is disinfectant?

A

antimicrobial used on inanimate object

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3
Q

Critical medical item

A
  • all devices used or placed via incision puncture
    ex: surgical instruments, catheters, orthopedic inplants
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4
Q

Semicritical medical item

A

devices that enters epithelium-lined lumen
ex: laryngoscopes, ET tube, flexible endoscope

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5
Q

noncritical medical item

A

hospital surfaces, external-applied devices

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6
Q

What sterilization is effective in the presence of gross organinc debris?

A

no sterilization or disinfectant

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7
Q

Radiation sterilization

A
  • use ionizing radiation
  • primarily industrial use
  • low-temp
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8
Q

What are radiation sterilization usually used on?

A

most disposable surgical supplies & some inplants

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9
Q

Steam sterilization through autoclave

A
  • coagulation & denaturation of cellular protein
  • high- temperature, pressurized steam
  • requires set duration
  • requires drying
  • reliable, non-toxic
  • cannot sterilize heat liable items
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10
Q

What happens when steam sterilization temperature increases?

A

time required decreases

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11
Q

What are required during heat sterilization?

A
  • require exposure for set duration
  • drying time
  • careful wrapping, loading of packs
  • PPE to avoid thermal burns
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12
Q

What is gravity dependent autoclave?

A
  • most common
  • steam enters from top & displace air through valve
  • temperature sensitive valve closes as steam enters
  • vacuum-dependent
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13
Q

What is vacuum dependent autoclave?

A
  • air removed prior to injection of steam
  • steam exposure time shorter
  • more expensive
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14
Q

What is “flash autoclave”?

A
  • type of autoclave use
  • single instrument unwrapped or single wrapped
  • placed on perforated metal tray
  • item transferred directly to surgical suit
  • emergency use only
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15
Q

What is ethylene oxide sterilization?

A
  • flammable, explosive toxic gas that alkylates microbial proteins, DNA, RNA
  • suitable for heat liable items
  • requires ventilation & purging of ethylene oxide outside
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16
Q

What to be mindful about when sterilizing with ethylene oxide?

A

toxic residue in combination with organic material

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17
Q

What is plasma sterilization?

A
  • H2O2 gas + UV radiation
  • plasma forms free radicals and oxidizes microbes
  • suitable for heat-liable items
  • shorter cycles
  • but can be unsuitable for linen, cotton, paper, plastics…etc
18
Q

What is cold sterilization?

A
  • instruments stored in high level disinfectant liquid (glutaraldehyde
  • safe for instruments
  • not truely sterilization
  • need to be rinsed thoroughly (can be toxic to tissues)
19
Q

What can cause failure of sterilization?

A
  • failure to clean instruments properly
  • failure to wrap pack
  • failure to load chambers properly
  • failure to use equipment properly
  • mechanical failure of equipment
20
Q

What should be done to prevent sterilization failure?

A
  • personnel must be properly trained
  • equipment properly maintained
  • indicators assist in monitoring of sterilization
21
Q

Chemical sterilization indicator

A
  • paper strip or tape with material that changes colour
  • colour change when exposed to condition
  • only confirm exposure to condition
22
Q

What does chemical sterilization not confirm?

A

duration of exposure to the condition

23
Q

What are the benefits of using biological sterilization indicators?

A
  • most reliable
  • confirms sterility
24
Q

What are the characteristics of biological sterilization indicators?

A
  • consist of viable spore-forming bacteria (self-contained for biosafety)
  • color change if culture +
  • positive test indicated failure of sterilization
  • more expensive than chemical indicator
25
Q

Characteristics of Cotton muslin as pack wrapping material

A
  • can be sterilized via steam & ethylene oxide
  • soft, reuseable, durable & inexpensive
  • generates lint
  • porous to bacteria
  • requires double layers
26
Q

What reduces pores of cotton muslin wrapping material?

A

higher thread count = less porous

27
Q

How to make cotton muslin wrapping material less water absorbant?

A

addition of coating can decrease absorbancy
- coating can wash off

28
Q

Paper as pack wrapping material

A
  • can sterilize with steam & ethylene oxide
  • inexpensive
  • non-woven (serves as barrier against bacteria)
  • disposable
  • fragile
  • has memory
  • requires double wrapping
29
Q

Polypropylene fabric as wrapping material

A
  • sterilize with steam & ethylene oxide
  • composed of 3 layers
  • highly effective bacterial barrier
  • water resistant
  • durable
  • environmental impact (plastic derivative, disposable)
  • double-wrap
30
Q

Heat-sealed pouch as wrapping material

A
  • 2 types: paper/ mylar & Tyvek/mylar
  • sterilized with ethylene oxide & steam (paper/ mylar); plasma (Tyvek/mylar)
  • convenient
  • long shelf life
  • water resistant
  • single-used
  • opened carefully to prevent contamination
31
Q

Sterile container system

A
  • steam-compatible only
  • good storage
  • durable & environmentally friendly
  • high start-up cost
  • has disposable or permanent filters
32
Q

What is the goal for wrapping packs?

A

pack easily unwrapped without breaking sterility

33
Q

What to do with packs after sterilization?

A
  • rack-dry without stacking
  • avoid condensation to prevent strikethrough
34
Q

What is strikethrough?

A

moisture penetrating porous material

35
Q

What to do once packs are fully dried?

A
  • label with date sterilized, expiration, initials & lot number
  • store in waterproof dust cover
  • protect from bending/ crushing…etc
36
Q

Ideal storage condition for sterilized packs

A
  • controlled room temp
  • low humidity
  • low air turbulence (away fromo HVAC)
  • closed cabinet
  • avoid stacking
37
Q

When to assume loss of sterility?

A
  • moisture/ strikethrough
  • damaged package
  • dust
38
Q

Recommended expiration dates for cloth

A
  • 4 weeks
  • with water-proof cover: 8 weeks
39
Q

Recommended expiration date for paper/ polypropylene

A

6 months

40
Q

Recommended expiration dates modifications are dependent on?

A

storage conditions & handling

41
Q

Rules for pouring sterile fluid into basin?

A
  • pour without touching container basin
  • fluid arcs into basin
  • do not splash
  • do not use the last 100 mL of fluid in bottle

Surgery (3 decks)

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